| NPI | 1396371209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 20A21100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM DO2025-0138) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-01-06 |